Insurers Are Starting to Cover Telehealth Abortion

As the fledgling industry of telehealth became more established and accepted in abortion care, the legal effort to ban mail order abortion pills was launched.

Hey Jane, a virtual abortion provider that has no physical location, is now contracting with insurers Anthem Blue Cross Blue Shield Connecticut, Empire Blue Cross Blue Shield New York, and Sana. Sana provides health insurance plans to small businesses across the country. Hey Jane already accepts Aetna for eight of its nine states.

Most virtual clinics only accept cash. It is rare for insurance companies to cover telehealth abortions. These clinics are relatively new and the insurance coverage for abortion is very variable. Just a third (of abortion patients) used insurance in the year prior to Roe v. Wade being overturned. Some states require that private insurers cover abortions while others do not. Although federal law prohibits Medicaid from covering most abortions, 16 states cover them with state funds. Even plans that cover abortions don't include telehealth providers as part of their networks.

The health insurance industry tends to cover treatments which are cost-effective and widely accepted by doctors. Hey Jane's partnership with Hey Jane is the latest indication that virtual abortion clinics have become a popular and safe option. Both patients and insurance companies tend to find them less expensive than clinic procedures.

Will Young, Sana's chief executive, stated that "in abortion care as well as so many other health care areas, we believe that expanding telehealth’s role is an enormous lever" to make care more affordable and accessible.

Gaby Santana said that not all insurance companies are ready to cover the new method of abortion. Some insurers require video visits and live visits. Hey Jane, on the other hand, sees its majority of patients via messaging. Hey Jane was told by other insurers that they only contract with clinics in a physical location.

Santana stated that her goal was to make the program as large and as accessible as possible. "We want to include more states and payers."

Honeybee, a leading online pharmacy that supplies abortion pills by mail, has reported filling over 10,000 prescriptions per month.

These clinics may also be hampered just as they begin to grow. Last week, the Fifth Circuit ruled that the Food and Drug Administration must ban telemedicine prescriptions and mail delivery of mifepristone. This is the first of the two drugs commonly prescribed to induce an abortion. This is a temporary order, while a Texas judge decides whether or not to reverse the drug's approval. The Supreme Court decided Friday that mifepristone will remain available until midnight on Wednesday, while the court reviews the case.

The F.D.A. In 2020, the F.D.A. allowed the first telemedicine abortion after a court ruling made in an emergency situation early in pandemic. This was in response to a decision by a local court that came out shortly before and extensive data showed it to be dependable and safe way to provide abortion pills to patients. In 2021, the policy was made permanent.

Jessica Nouhavandi is the co-founder and CEO of Honeybee. She said that pharmacists need to be certified in order to dispense mifepristone. They also must report information about each prescription. She said, "I literally had to create protocols and train the pharmacists." "Most students don't learn about this at school."

Most start-up clinics are located in a limited number of states. They must also have clinicians licensed in every state where they treat patients. Investors or grant-makers finance some clinics as they learn how to run a profitable business. Few businesses have attorneys on staff who can help them navigate recent legal challenges.

They formed an unofficial group to share information and ask questions about legal issues or electronic medical records. Plan C is a nonprofit that offers consulting, small grants and a database with providers.

The F.D.A. has begun to discuss what it will do in the event that the court case leads the F.D.A. They have begun discussing what they will do if the court case prompts the F.D.A. Misoprostol is the only other medicine that many are considering offering. It can be effective in ending a pregnancy when used alone, but it has more side effects.

Dr. Rachna Kul is the sole practitioner of Maitri Wellness in New Jersey. She began offering telemedicine abortions during the pandemic and her office now mails out dozens of pills packs per day to three states in which she is licensed. She charges patients who are able to pay cash for the service and grants for those who cannot.

Dr. Kaul stated that because she is self-employed, it was easier for her to provide the service than other colleagues. She said, "In the early days, we had no funding so we paid for everything ourselves." I could work anywhere else and earn so much money. "This is such an urgent need."

Two midwives who work in a New York City clinic and hospital during the day run Juniper Midwifery. They provide 175 medication-abortion procedures per month to women from six states. They work from home or on the move.

Marisa and Jillian Barovick, who founded Juniper together, said: "It's only the two of us." "We're in the grass-roots stage of things. This week felt a bit tense. "Are we going to continue doing this, and provide access to people this way?"

Juniper's first patients were seen in August. Ms. Poverman created the website with WordPress and their husbands shot their headshots. To get the project off the ground they raised money from family and friends. Now, New York State has granted them a grant. The grant is used to subsidise prices or to provide free care for patients in need.

Hey Jane is a provider that has been around for a long time, and it's one of the best-established. They have invested $9,6 million in venture capital, and they employ 40 people. Abortion on Demand, Aid Access and Hey Jane are the most popular providers in many states. Aid Access has a separate branch that operates in states with abortion laws by connecting women to doctors and pharmacies overseas.

Carafem, another large operation, is a provider of telehealth abortions that operates in 16 states. They also have a few physical clinics. Melissa Grant, chief operating officer of Carafem, stated that learning the different rules of each state was one of the most difficult parts of running her business.

Insurance coverage questions reflect and amplify these complications. Ms. Grant says her providers are working hard to explain to patients what their insurance plans cover, and they're trying to convince more health plans that the company is a good partner.

She said that not all insurance plans cover abortion. "When you add telehealth to it, there are unfortunately a lot of carriers who deny care."

Even if patients have insurance, they may not want to use it. Dr. Stephanie Colantonio is a primary physician in California who provides telemedicine abortions through Luna Flow Health. She said that some patients are worried about their privacy and security, so they choose to pay for the procedure themselves.